Hepatic portal vein branching patterns according to different liver assessment methods and classifications of branching type.

BACKGROUND: It is known that there are varying frequencies of hepatic portal vein branching patterns found in the literature. Studies use different methods and classifications to evaluate the anatomy of the portal vein, which limits accurate comparison between studies and the determination of true frequency of branching patterns in different populations. The aim of the present study was to investigate the intrahepatic branching of the portal vein in corrosive samples using different methods - somatoscopic and computed tomography (CT) and compare with similar studies as well as compare the reclassified data according to the most popular classifications used in the literature. METHODS: A total of 105 liver corrosion specimens from the 1960-1980 period (51 male and 54 female individuals; min-max age variation - 21-90 y., M=59,46 y.) were investigated. The branching patterns of the hepatic portal vein (HPV), left (HPV-LB) and right branch of hepatic portal vein (HPV-RB), and their segmental branches were examined and scanned by CT. Standard HPV ramification was considered, when HPV divided into HPV-LB and HPV-RB, HPV-RB bifurcated to the anterior and posterior branches, and further segmental ramification into the superior and inferior branches was considered standard. We compared the HPV main branch length and diameter measurements between manual and CT method. A review of the literature was performed on portal vein branching variations. RESULTS: The standard HPV ramification pattern was detected in 85.7% of the cases in both somatoscopic and CT evaluation. Variations related to the main branches were HPV trifurcation - 7.6%, posterior branch of right branch of hepatic portal vein from HPV - 4.8% and 5.7%, HPV quadrifurcation 1.9% and 1% respectively, in somatoscopic and CT evaluation. There was a significant difference between HPV-LB length and diameter in CT and manual measurements. According to the literature, more variations are seen using the CT method versus somatoscopic corrosion cast evaluation. The varying frequency in studies may be explained by a lack of one unanimous classification of branching patterns (some authors do not consider segmental variations as standard HPV ramification) and different evaluation methods. CONCLUSION: Somatoscopic evaluation of the branching patterns of the hepatic portal vein in corroded specimens and their CT reconstructions did not differ significantly (which allows relatively accurate comparison of old specimens with newer data). However, the ability to evaluate the reconstructed 3D images of the specimens allowed a more accurate assessment of segmental branching and measurements of lengths and diameters. Standard HPV branching (according to a self-developed classification) in this study was 85.7%. Depending on the classification, the rate of standard branching in the same corrosive samples varied from 63.8% to 84.8% of all cases, indicating that the lack of a unified and stable classification makes it difficult to compare the results of different studies. Deviations from standard branching are very important in surgical procedures and liver transplantation.

Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study.

OBJECTIVE: To identify the incidence and risk factors of haemorrhoids and fissures during pregnancy and after childbirth. DESIGN: Prospective observational cohort study. SETTING: University hospital and outpatient clinics in Lithuania. POPULATION: A total of 280 pregnant women followed up until 1 month after delivery. METHODS: Women were examined four times through pregnancy and after delivery; those that developed peri-anal diseases were compared with those that did not. MAIN OUTCOME MEASURES: Incidence, time and risk factors of haemorrhoids and fissures. RESULTS: In all, 123 (43.9%) women developed peri-anal disease: 1.6% in the first trimester, 61% during the third trimester, 34.1% after delivery and 3.3% 1 month after delivery; 114 (40.7%) women were diagnosed with haemorrhoids, seven (2.5%) with haemorrhoids and anal fissure and two (0.71%) with anal fissure. Ninety-nine (80.5%) women had vaginal delivery and 24 (19.5%) women had undergone caesarean section. Multivariate analysis identified personal history of peri-anal diseases (odds ratio [OR] 11.93; 95% confidence interval [95% CI] 2.18-65.30), constipation (OR 18.98; 95% CI 7.13-50.54), straining during delivery for more than 20 minutes (OR 29.75; 95% CI 4.00-221.23) and birthweight of newborn>3800 g (OR 17.99; 95% CI 3.29-98.49) as significant predictors of haemorrhoids and anal fissures during pregnancy and perinatal period. CONCLUSIONS: Haemorrhoids and fissures are common during the last trimester of pregnancy and 1 month after delivery, with constipation, personal history of haemorrhoids or fissures, birthweight of newborn>3800 g, straining during delivery for more than 20 minutes being independently associated risk factors.

The juvenile face as a suitable age indicator in child pornography cases: a pilot study on the reliability of automated and visual estimation approaches.

OBJECTIVE: In cases of suspected child pornography, the age of the victim represents a crucial factor for legal prosecution. The conventional methods for age estimation provide unreliable age estimates, particularly if teenage victims are concerned. In this pilot study, the potential of age estimation for screening purposes is explored for juvenile faces. In addition to a visual approach, an automated procedure is introduced, which has the ability to rapidly scan through large numbers of suspicious image data in order to trace juvenile faces. METHODS: Age estimations were performed by experts, non-experts and the Demonstrator of a developed software on frontal facial images of 50 females aged 10-19 years from Germany, Italy, and Lithuania. To test the accuracy, the mean absolute error (MAE) between the estimates and the real ages was calculated for each examiner and the Demonstrator. RESULTS: The Demonstrator achieved the lowest MAE (1.47 years) for the 50 test images. Decreased image quality had no significant impact on the performance and classification results. The experts delivered slightly less accurate MAE (1.63 years). Throughout the tested age range, both the manual and the automated approach led to reliable age estimates within the limits of natural biological variability. CONCLUSIONS: The visual analysis of the face produces reasonably accurate age estimates up to the age of 18 years, which is the legally relevant age threshold for victims in cases of pedo-pornography. This approach can be applied in conjunction with the conventional methods for a preliminary age estimation of juveniles depicted on images.

Metric and morphological assessment of facial features: a study on three European populations.

Identification from video surveillance systems is becoming more and more frequent in the forensic practice. In this field, different techniques have been improved such as height estimation and gait analysis. However, the most natural approach for identifying a person in everyday life is based on facial characteristics. Scientifically, faces can be described using morphological and metric assessment of facial features. The morphological approach is largely affected by the subjective opinion of the observer, which can be mitigated by the application of descriptive atlases. In addition, this approach requires one to investigate which are the most common and rare facial characteristics in different populations. For the metric approach further studies are necessary in order to point out possible metric differences within and between different populations. The acquisition of statistically adequate population data may provide useful information for the reconstruction of biological profiles of unidentified individuals, particularly concerning ethnic affiliation, and possibly also for personal identification. This study presents the results of the morphological and metric assessment of the head and face of 900 male subjects between 20 and 31 years from Italy, Germany and Lithuania. The evaluation of the morphological traits was performed using the DMV atlas with 43 pre-defined facial characteristics. The frequencies of the types of facial features were calculated for each population in order to establish the rarest characteristics which may be used for the purpose of a biological profile and consequently for personal identification. Metric analysis performed in vivo included 24 absolute measurements and 24 indices of the head and face, including body height and body weight. The comparison of the frequencies of morphological facial features showed many similarities between the samples from Germany, Italy and Lithuania. However, several characteristics were rare or significantly more or less common in one population compared to the other two. On the other hand, all measurements and indices, except for labial width and intercanthal-mouth index showed significant differences between the three populations. As far as comparisons with other samples are concerned, the three European Caucasian samples differed from North American Caucasian, African and Asian groups as concerns the frequency of the morphological traits and the mean values of the metric analysis. The metric and morphological data collected from three European populations may be useful for forensic purposes in the construction of biological profiles and in screening for personal identification.